| NPI | 1821399239 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: VA 0102202428) |
| Additional Taxonomies | 174400000X Specialist (Licence: MD H0081237) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: ND 19096) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: WY 15141C) | |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2023-12-28 |